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The accumulation of fumaric acid may also have an inhibitory effect on argininosuccinate lyase in the urea cycle, which affects the urea cycle and increases the amount of citrulline in biochemical tests

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for instance, in hepatocellular carcinoma cells, PCSK9 suppressed tumor growth and the M2 phenotype (Hu et al., 2022), once again demonstrating pro-inflammatory effects that are opposite to what was reported in other cancer models